• Respiratory care · Jan 2018

    Review

    The Role of Rescue Therapies in the Treatment of Severe ARDS.

    • Francesco Alessandri, Francesco Pugliese, and V Marco Ranieri.
    • Sapienza University of Rome, Department of Anesthesia and Critical Care Medicine, Policlinico Umberto I, Rome, Italy. francesco.alessandri@uniroma1.it.
    • Respir Care. 2018 Jan 1; 63 (1): 92-101.

    AbstractARDS is characterized by a non-cardiogenic pulmonary edema with bilateral chest radiograph opacities and hypoxemia refractory to oxygen therapy. It is a common cause of admission to the ICU due to hypoxemic respiratory failure requiring mechanical ventilation. Corticosteroids are not recommended in ARDS patients. Rescue therapies alleviate hypoxemia in patients unable to maintain reasonable oxygenation: recruitment maneuvers, prone positioning, inhaled nitric oxide, high-frequency oscillatory ventilation, and extracorporeal membrane oxygenation improve oxygenation, but their impact on mortality remains unproven. Restrictive fluid management seems to be a favorable strategy with no significant reduction in 60-d mortality. Future studies are needed to clarify the efficacy of these therapies on outcomes in patients with severe ARDS, and institution of these therapies may be considered on a case-by-case basis.Copyright © 2018 by Daedalus Enterprises.

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